Résumé
Objective To investigate the short-term efficacy of plasma exchange(PE),PE combined with double plasma molecule absorption system(PE+DPMAS) for treating severe hepatitis B(SHB).Methods The clinical data in 70 patients with SHB were retrospectively analyzed.The patients were divided into the PE group and PE+-DPMAS group according to different treatment modes.The clinical symptoms,liver function,coagulation function,blood routine,renal function and electrolytes changes,score decrease of model for end-stage liver disease(MELD) before and after treatment were compared between the two groups.Results After treatment,the alimentary tract symptoms were improved,the grade of hepatic encephalopathy was reduced and MELD score was decreased,but there was no statistically significant difference in the short-term effective rate between the two groups(P＞0.05).After treatment ALT,TBIL,RBC,Hb and PLT in the two groups were decreased significantly(P＜0.05);the ALB level in the PE+DPMAS group was decreased,while K+ and C1 were increased(P＜0.05);the PTA and ALB levels in the PE group were increased,while WBC was decreased in the PE group(P＜0.05).Conclusion The two kinds of treatment method PE and PE-+DP-MAS are effective in treating SHB.PE+-DPMAS can reduce the plasma usage and improve serum K+,Cl-levels;PE is superior to PE+DPMAS in the aspects of improving coagulation function and ALB level.
Résumé
Objective In this study ,the effect of Spirulina kinase(SPK)on hemorheology ,platelet aggregation and cAMP in acute blood stasis rats model were investigated .Methods Forty SD rats were randomly divided into normal control group ,model group ,aspirin group and the high and low dose of SPK groups .All treatments were performed by gavage once a day for 7 days .Sub-cutaneous injection of adrenalin combined with ice water bath were used to establish the acute blood stasis rat model .The whole blood viscosity ,plasma viscosity ,red blood cell hematocrit (Hct) ,erythrocyte aggregation index (EAI) ,red blood cell deformation index(DI)anderythrocyterigidityindex(ERI)weredetectedbyautomaticbloodflow speedanalyzer .Meanwhile,thelevelofcAMP was detected by ELISA method .Rat platelet aggregation induced by ADP and the maximum aggregation rate was measured by tur-bidimetry .Results Results showed that SPK could significantly decrease the whole blood viscosity ,plasma viscosity ,Hct ,EAI and platelet aggregation rate ,increase the level of cAMP compared with model group(P<0 .05) ,but had no effect on DI and ERI .Con-clusion SPK can markedly improve the abnormal changes of hemorheology in acute blood stasis rats and inhibit the platelet aggregation .
Résumé
Objective To investigate the effect of different intervention times on the efficacy of catheter balloon dilatation therapy for cricopharyngea] achalasia after stroke.Methods Forty-eight cases diagnosed as cricopharyngeal achalasia were divided into 4 groups,groups A,B,C,and D according to the time of intervention from the onset (i.e.0.5,0.5-1,1-3,and 3-6 months),with 12 cases in each group.A 14# urethral catheter was inserted into the esophagus and water was injected into the balloon to make it turgid.The catheter was then pulled upwards through the stricture in the esophagus to dilatate the cricopharygeal muscle.The patients also received low frequency electrical stimulation combined with dysphagia rehabilitation behavioral therapy once daily.The treatment end point was either when the patient resumed an oral diet or after 6 weeks of treatment.The effects of the treatment were evaluated in terms of the number of times the dilatation therapy was administered,the pharyngeal transit duration,swallowing function and fluoroscopic examination before and after treatment.Results Groups A,B and C required significantly fewer treatment sessions than group D.Groups A and B required significantly fewer sessions than group C,but the difference between groups A and B was not statistically significant.After treatment,there were 11 patients can eat water,liquid,paste and solid food both in groups A and B.But the number of patients who can eat the4 traits of food was 9,9,10,9 in group C and 6,6,7,5 in group D respectively.Swallowing function in groups A,B and C was adjudged,on average,significantly better than in group D.Compared with group C,swallowing function in groups A and B was also significantly improved,but the difference between groups A and B was not statistically significant.The pharyngeal transit duration in all 4 groups was shorter than before treatment,but the duration in groups A,B and C was significantly shorter than in group D.Compared with group C,the pharyngeal transit duration in groups A and B was significantly shorter,but the difference between groups A and B was again not statistically significant.Fluoroscopy showed the efficiency in groups A and B to be over 91 ％.In group C it was 83％ and in group D 58％.The difference between group D and groups A,B and C was significant.The efficiency in groups A and B was significantly better than in group C,but the difference between groups A and B again was not statistically significant.Conclusions Early intervention using catheter balloon dilatation therapy can facilitate the improvement of swallowing function in patients with cricopharyngeal achalasia after stroke and improve their quality of life.
Résumé
@#Objective To explore the effects of catheter balloon dilatation therapy on cricopharyngeal achaiasia in patients with stroke and 1 year follow-up study. Methods 28 cases of dysphagia caused by stroke were diagnosed as cricopharyngeal achalasia through videofluoroscopic swallowing study (VFSS). A l4# urethral catheter was used to insert into the esophagus and an amount of water was injected into the balloon of urethral catheter to make it turgid. Then the catheter was pulled upwards and passed through the stricture of esophagus to dilatate the cricopharygeus muscle. At the same time, vitalstim low frequency electrical stimulation was used and combined with routine dysphagia rehabilitation training once daily. The treatment end point was either the patient resuming an oral diet or after 6 weeks of treatment. All cases were evaluated by swallowing function and VFSS before and after treatment and followed after 1 year of treatment. Results After catheter balloon dilatations therapy, 22 patients regained the ability to take solid food and water orally, 24 of them could take pasty food. There was significant difference between pre-treatment and post-treatment (P<0.01). The time of bolus passing the pharynx significantly shortened from 0.22 s to 0.14 s after treatment. The scores of VFSS significantly increased after treatment (P<0.01). VFSS showed that the total effective rate was 89.28%. 1 year after treatment, 23 patients could take solid food and water orally, and 12 patients approach to normal in the time passing the pharynx and VFSS score. Conclusion Catheter balloon dilatation has long-term effect on cricopharyngeal achalasia caused by stroke.